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Individual
DR. FREDERICK D EDWARDS
Active
Individual
DR. FREDERICK D EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12122
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336166
—
AZ
01
—
86080015085259A049
TRIWEST
AZ
01
—
86080015085260A003
TRIWEST
AZ
Enumeration date
11/23/2005
Last updated
10/29/2007
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